1,721,317 research outputs found
Radiofrequency thermal ablation vs percutaneous ethanol injection for small hcc in cirrhosis:metanalysis of randomized controlled trials
No full text1. Am J Gastroenterol. 2009 Feb;104(2):514-24. Epub 2009 Jan 13.
Radiofrequency thermal ablation vs. percutaneous ethanol injection for small
hepatocellular carcinoma in cirrhosis: meta-analysis of randomized controlled
trials.
Orlando A, Leandro G, Olivo M, Andriulli A, Cottone M.
Department of Medicine, Pneumology and Nutrition Clinic, V. Cervello Hospital,
University of Palermo, Piazza Mameli 1, Palermo, Italy. [email protected]
OBJECTIVES: Radiofrequency thermal ablation (RF) and percutaneous ethanol
injection (PEI) have been employed in the treatment of small hepatocellular
carcinoma (HCC) as curative treatments. The aim of the study was to review the
available evidence comparing RF to PEI for small HCC.
METHODS: Search strategy: Cochrane, MEDLINE, CANCERLIT, and ENBASE databases were
used. Selection criteria: randomized clinical trials evaluating RF vs. PEI. Data
were extracted from each randomized controlled trial (RCT). Primary outcomes were
overall survival and local recurrence. Meta-analysis software was used and risk
differences (RDs) and their 95% confidence intervals and Q-test for heterogeneity
were calculated.
RESULTS: Five RCTs were identified including 701 patients. The overall survival
was significantly higher in patients treated with RF than in those treated with
PEI (RD 0.116, 95% CI 0.173/0.060; heterogeneity not present). Local recurrence
rate is significantly higher in patients treated with PEI than in those treated
with RF. In the RF group the 1, 2, and 3 years cancer-free survival rates were
significantly better than in the PEI-treated patients (respectively: RD 0.098-95%
CI 0.006/0.189; heterogeneity P=0.57; RD 0.187, 95% CI 0.082/0.293; heterogeneity
P=0.98; RD 0.210, 95% CI 0.095/0.325; heterogeneity P = 0.78). A small number of
adverse events were reported in the two treatments.
CONCLUSIONS: RF ablation is superior to PEI in the treatment of small HCC with
respect to overall survival, 1, 2, and 3 years survival rates, 1, 2, and 3
cancer-free survival rates, and tumor response. RF shows a significantly smaller
risk of local recurrence
Risk of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis and Ways to Prevent It: Old Myths, a Current Need? The Case of Allopurinol
No full textEsophageal achalasia: A mistery with different solutions
No full textAchalasia is still an intrigning "mistery" and although different "solutions" are available, the definitive "cure" is missing. The present review summarizes the available data in the literature regarding drug therapy, the use of botolinum toxin intrasphinteric injection, and pneumatic dilation while direct comparative information is still lacking, some guidelines on therapeutic options can be given
Usefulness of a liver biopsy in the evaluation of patients with elevated ALT values and serological markers of hepatitis viral infection (Collaborazione).
No full text
Contemporary 24-hour ambulatory recording of the electrogastrogram and gastrointestinal manometry
No full textThe aminopyrine breath test
No full textThe metabolic basis and clinical application of the aminopyrine breath test (ABT) as a measure of liver function is reviewed in this article. Several papers have been published in the 20 years that have elapsed since the test was validated in man by Hepner and Vesell. Nevertheless, even if the aminopyrine breath test has been shown to be a non-invasive, reliable and semiquantitative liver function test with diagnostic and prognostic accuracy, it is not yet extensively used in clinical practice, probably because it is not widely known to clinicians. The aminopyrine breath test, like other newer tests (phenacetin, caffeine and erythromycin breath tests), allows the effects of drugs on hepatic cytochrome P-450 to be explored both in normal subjects and in liver patients. This interesting field of application is sure to expand the appeal of the aminopyrine breath test in the future
Microscopic colitis progressed to collagenous colitis: A morphometric study
No full textMicroscopic (also called lymphocytic) colitis and collagenous colitis are two newly recognised clinicopathologic entities of unknown aetiology presenting with chronic watery diarrhoea. In both conditions, the colon appears normal by barium enema and colonoscopy, however, colonic biopsies reveal infiltration of plasma cells and neutrophils within the lamina propria and increased intraepithelial lymphocytes within the surface epithelium. Lack of a thickened collagen band beneath the surface epithelium histologically differentiates microscopic from collagenous colitis. The exact relationship between the two disorders is as yet unknown. The two entities may be variants of the same spectrum of disease or distinct conditions with and without collagen table thickening. The present case report shows progression of microscopic colitis to collagenous colitis in sequential colonic biopsies taken from a patient during a 7-year endoscopic follow-up suggesting that progression of microscopic to collagenous colitis is a possibility and the two diseases are likely to represent variants of the same condition
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